Influence of a Child’s Chronic Illness On Family Dynamics as Perceived by Family Members/Caregivers in Teaching Hospitals in Enugu Metropolis.

Abstract Chronic illness is the term used to describe diseases which have non-reversible pathological condition that cannot be corrected by medical intervention. Examples include sickle cell disease, cancer, Aids, bronchial asthma among others. Many children are affected by chronic illness and cared for in the homes. The diagnosis of chronic illness in a child evokes a lot of influences on the dynamics of both immediate and extended families. This study investigated the influence of a child’s chronic illness on family dynamics as perceived by family members/caregivers in Enugu metropolis. Descriptive survey design of qualitative and quantitative was used. Four objectives of the study were to: determine the influence of a child’s chronic illness on family cohesion; determine the influence of a child’s chronic illness on family flexibility; determine the influence of a child’s chronic illness on the communication pattern in the family and identify the construct of the family dynamics mostly affected by a child’s chronic illness. A population of four hundred (400) adult family members/caregivers who met the inclusion criteria was purposively selected. A 5 point Likert scale questionnaire with a reliability of 0.73 after the face and content validation was used for data collection as well as an in depth interview guide. Descriptive statistics of frequencies, mean and standard deviation including descriptive phenomenological transcription were used for data analysis. Findings revealed that a child’s chronic illness resulted in good family cohesion evidenced by love, concern, support, sensitive, closeness to one another that many were unhappy, moody, sorrowful, and even cried during times of their sick one’s crisis. On family flexibility, finding revealed decision making by parents with inputs from family members, adjustment in performance of roles, joint problem solving with mother and older female siblings doing more work. The family communication was cordial and accommodating but a significant number reported reduced verbal communication characterized by irritability and disjointedness when asked questions. Family flexibility is the most affected dynamic construct. In conclusion, the participants perceived a lot of influence by the child’s chronic illness. In recommendation, there is need for knowledge update on child’s chronic illness for families, caregivers, health workers as well as encouraging community based support networks for the chronically ill families to ensure good care for this vulnerable group.

Table of Contents

Title - - - - i

Approval - - - - ii

Certification - - - - iii

Dedication - - - - iv

Acknowledgement - - - - v

Table of Contents - - - - vi

List of Tables - - - - ix

List of Appendices - - - - x

Abstract - - - - xi

CHAPTER ONE: INTRODUCTION

Background to the Study - - - 1

Statement of Problem - - - 7

Purpose of the Study - - - 9

Research Objectives - - - 9

Research Questions - - - 9

Significance of the Study - - - 10

Scope of the Study - - - 11

Operational Definition of Terms - - - 12

CHAPTER TWO: LITERATURE REVIEW

Conceptual Review - - - 15

Conceptual of Chronic Illness - - - 15

Chronic Illness in Children - - - 16

Families and Sibling of Families with a Child in Chronic Health Conditions - 17

Concept of Family Dynamics - - - 21

Concept of Family Cohesion - - - 22

Concept of Family Flexibility - - - 23

Concept of Family Communication - - - 24

Influence of Child’s Chronic Illness on Family Cohesion, Flexibility and

Communication. - - - 26

The Family System Theory - - - 32

Empirical Review - - - 35

Summary of Literature Review and Analysis of Empirical Review - - 40

CHAPTER THREE: RESEARCH METHOD

Research Design - - - 42

Area of Study - - - 42

Population of the Study - - - 43

Sample - - - 44

Inclusion Criteria - - - 44

Instrument for Data Collection - - - 45

Validity of the Instrument - - - 46

Reliability of Instrument - - - 46

Ethical Consideration - - - 46

Procedure for Data Collection - - - 47

Method of Data Analysis - - - 48

CHAPTER FOUR: PRESENTATION OF RESULTS

Summary of Findings - - - 49

CHAPTER FIVE: DISCUSSION OF FINDINGS

Discussion of Major Findings - - - 79

Summary of the Study - - - 84

Implication of the Study to Nursing - - - 85

Conclusion - - - 87

Recommendations - - - 88

Limitation of the Study - - - 88

Suggestion for further Studies - - - 89

References

Appendices